The association between glucagon-like peptide-1 (GLP-1) receptor agonists and the risk of various kinds of thyroid disorders remains uncertain. We aimed to evaluate the relationship between the use of GLP-1 receptor agonists and the occurrence of 6 kinds of thyroid disorders. We searched PubMed (MEDLINE), EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science from database inception to 31 October 2021 to identify eligible randomized controlled trials (RCTs). We performed meta-analysis using a random-effects model to calculate risk ratios (RRs) and 95% confidence intervals (CIs). A total of 45 trials were included in the meta-analysis. Compared with placebo or other interventions, GLP-1 receptor agonists’ use showed an association with an increased risk of overall thyroid disorders (RR 1.28, 95% CI 1.03-1.60). However, GLP-1 receptor agonists had no significant effects on the occurrence of thyroid cancer (RR 1.30, 95% CI 0.86-1.97), hyperthyroidism (RR 1.19, 95% CI 0.61-2.35), hypothyroidism (RR 1.22, 95% CI 0.80-1.87), thyroiditis (RR 1.83, 95% CI 0.51-6.57), thyroid mass (RR 1.17, 95% CI 0.43-3.20), and goiter (RR 1.17, 95% CI 0.74-1.86). Subgroup analyses and meta-regression analyses showed that underlying diseases, type of control, and trial durations were not related to the effect of GLP-1 receptor agonists on overall thyroid disorders (all P subgroup > 0.05). In conclusion, GLP-1 receptor agonists did not increase or decrease the risk of thyroid cancer, hyperthyroidism, hypothyroidism, thyroiditis, thyroid mass and goiter. However, due to the low incidence of these diseases, these findings need to be examined further.Systematic Review RegistrationPROSPERO https://www.crd.york.ac.uk/prospero/, identifier: CRD42021289121.

The risk of cardiovascular diseases is closely related to diabetes. Macrovascular disease is the main cause of death and disability in patients with type 2 diabetes. In recent years, the glucagon-like peptide-1 receptor agonist (GLP-1RA), a new type of hypoglycemic drug, has been shown to regulate blood sugar levels, improve myocardial ischemia, regulate lipid metabolism, improve endothelial function, and exert a protective role in the cardiovascular system. This study reviewed the protective effects of GLP-1RA on the cardiovascular system.

Context C1q/TNF-Related Protein-9 (CTRP9) appears to be linked to type 2 diabetes mellitus (T2DM), according to growing research. But the literature on circulating levels of CTRP9 in patients with T2DM has been contradictory. Objective This is a systematic review and meta-analysis to reassess the circulating level of CTRP9 in patients with T2DM, with and without complications. Data Source Relevant studies published until October 31 2021, were identified from the PubMed, Embase, Web of Science, The Cochrane Library, WanFang, CNKI, VIP, and CBM databases. Study selection Participants with age ≥ 18 years with clinically diagnosed T2DM. Sex and diabetes complication type were not restricted. Data extraction The data were extracted by 2 reviewers independently using a standard data collection form. Data Synthesis Analysis demonstrated significantly lower circulating levels of CTRP9 in patients with T2DM in comparison to patients without diabetes [(SMD=-1.36; 95%CI (-1.78 to -0.93); P<0.001), I2=97.5%, P<0.001]. Furthermore, the circulating level of CTRP9 in patients with T2DM related complications is lower than that in patients with T2DM without complications, regardless of macrovascular complications or microvascular complications [(SMD=-1.062; 95%CI (-1.466 to -0.658); P<0.001), I2=91.3%, P<0.001]. Subgroup analyses revealed that factors such as body mass index (BMI), T2DM duration, and fasting glucose (FBS) were the sources of heterogeneity (P=0.047, P=0.034, and P=0.07, respectively). Conclusions The present systematic review and meta-analysis found CTRP9 levels were lower in T2DM patients with or without complications. However, since it is a meta-analysis of most observational studies, these findings still need to be verified by further studies with a large sample size.